Equal Power and Voice and Silence on Patient Safety in the Surgeon-Anaesthesiologists Relationship

Abstract

Research has found conflicting effects of equal and unequal power relationships on broad organisational outcomes. However, scholars have solely examined voice and silence in unequal power relationships leaving a dearth of knowledge on how the phenomenon unfold among equals. Exploring this research gap therefore has prospects of advancing new knowledge that can address problems to aid team and organisational effectiveness. Drawing on insights from functional and conflict theories of power, a qualitative study of surgeons and anaesthesiologists found that equal power breeds intense power struggles and rivalry in interdependent work relationships. While this promotes effective voice on safety concerns in each’s speciality, it undermines voice across speciality and sometimes degenerates into ill-motivated voice used as a control, which is often not in the real teams and patient safety interest. These suggest that active voice in equal power relationships may not always be helpful to team and organisational outcomes. Promoting a shared and cooperative leadership in equal power relationships will therefore help to mitigate power struggles and enhance constructive voice for better work outcomes. Theoretically, this study demonstrates equal power as having dynamic double-edged effects than it is often conceptualised as positive and negative by functionalists and conflicts theories of power respectively. Key Words: Power, Conflict, Voice and Silence, Patient Safety, Surgeons and Anaesthesiologists